{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T18:38:19Z","timestamp":1792694299712,"version":"4.5.0"},"reference-count":75,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014476","name":"Pfizer Pharmaceuticals","doi-asserted-by":"publisher","award":["88606701"],"award-info":[{"award-number":["88606701"]}],"id":[{"id":"10.13039\/100014476","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Wolfond Chair in Digital Health"}],"content-domain":{"domain":["www.plosdigitalhealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Digit Health"],"abstract":"<jats:p>\n                    Juvenile idiopathic arthritis (JIA) is the most common pediatric chronic inflammatory rheumatic condition, with substantial quality-of-life impacts. Treatment selection is complex due to limited guideline evidence, and difficult trade-offs. Decisions are often solely physician driven. We evaluated the feasibility of Large Language Model-based Decision Aid (LLM-DA) designed to support collaborative rather than solely physician decision-making in JIA care. A multi-method feasibility study was conducted in accordance with the TRIPOD-LLM checklist. The aims were twofold: first, to assess the quality of the LLM-DA (OpenAI\u2019s o3 model) based on evaluations from three pediatric rheumatologists and an exploratory assessment by an LLM-as-a-Judge (OpenAI\u2019s GPT-5 model); and second, to characterize perceived value of the tool from the patient perspective through a mixed methods evaluation (n\u2009=\u200934). For 10 de-identified use cases, rheumatologists and LLM-Judge generated treatment recommendations and scored the LLM-DA outputs on safety, factual consistency, treatment appropriateness, and preference acknowledgment. Rheumatologists rated 97% of outputs as acceptable for safety and preference acknowledgment, 60% for factual consistency, 70% for appropriateness. Treatment recommendation agreement among all evaluators and real-world data was low at &lt;30%. Inter-rater agreement for scores among rheumatologists was\n                    <jats:italic>almost perfect<\/jats:italic>\n                    for safety and preference acknowledgement,\n                    <jats:italic>moderate<\/jats:italic>\n                    for treatment appropriateness, and\n                    <jats:italic>poor<\/jats:italic>\n                    for factual consistency, and remained the same or improved with LLM-as-a-Judge. Variability in evaluator scoring and treatment recommendations may reflect the inherent heterogeneity in acceptable JIA treatment pathways and potential limitations in the LLM-DA\u2019s decision-making logic. Five patient themes were identified: the tool complements rheumatologist expertise, prepares patients through reflection and actionable information, builds confidence for self-advocacy, has variable value depending on the patient-physician relationship, and has potential for broader JIA self-management. These exploratory findings provide a proof-of-concept for using AI to support collaborative decision-making, while highlighting the need for future studies to determine whether LLMs can reliably support clinical practice.\n                  <\/jats:p>","DOI":"10.1371\/journal.pdig.0001655","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T17:42:40Z","timestamp":1792690960000},"page":"e0001655","update-policy":"https:\/\/doi.org\/10.1371\/journal.pdig.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["An LLM-based decision aid for collaborative decision-making in juvenile idiopathic arthritis: A multimethod evaluation"],"prefix":"10.1371","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8271-2030","authenticated-orcid":true,"given":"Antonia","family":"Barbaric","sequence":"first","affiliation":[{"name":"University of Toronto","place":["Toronto, Ontario, Canada"],"department":["Institute of Health Policy, Management, and Evaluation"]},{"name":"University Health Network","place":["Toronto, Ontario, Canada"],"department":["Centre for Digital Therapeutics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne M.","family":"Benseler","sequence":"additional","affiliation":[{"name":"University of Calgary","place":["Calgary, Albereta, Canada"],"department":["Department of Pediatrics, Cumming School of Medicine"]},{"name":"Trinity College Dublin","place":["Dublin, Ireland"],"department":["Children\u2019s Health Ireland, and University College Dublin"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chitra","family":"Lalloo","sequence":"additional","affiliation":[{"name":"University of Toronto","place":["Toronto, Ontario, Canada"],"department":["Institute of Health Policy, Management, and Evaluation"]},{"name":"The Hospital for Sick Children","place":["Toronto, Ontario, Canada"],"department":["Child Health Evaluative Sciences, Research Institute"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyi Celine","family":"Liu","sequence":"additional","affiliation":[{"name":"University of Toronto","place":["Toronto, Ontario, Canada"],"department":["Institute of Health Policy, Management, and Evaluation"]},{"name":"University Health Network","place":["Toronto, Ontario, Canada"],"department":["Centre for Digital Therapeutics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9986-3345","authenticated-orcid":true,"given":"Alex","family":"Mariakakis","sequence":"additional","affiliation":[{"name":"University of Toronto","place":["Toronto, Ontario, Canada"],"department":["Department of Computer Science"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quynh","family":"Pham","sequence":"additional","affiliation":[{"name":"University of Toronto","place":["Toronto, Ontario, Canada"],"department":["Institute of Health Policy, Management, and Evaluation"]},{"name":"University Health Network","place":["Toronto, Ontario, Canada"],"department":["Centre for Digital Therapeutics"]},{"name":"University of Ottawa","place":["Ottawa, Ontario, Canada"],"department":["Telfer School of Management"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastiaan J.","family":"Vastert","sequence":"additional","affiliation":[{"name":"Wilhelmina, Children\u2019s Hospital, University Medical Center Utrecht","place":["Utrecht, The Netherlands"],"department":["Department of Pediatric Rheumatology and Immunology"]},{"name":"Utrecht University","place":["Utrecht, The Netherlands"],"department":["Faculty of Medicine"]},{"name":"University Medical Center Utrecht","place":["Utrecht, The Netherlands"],"department":["Center for Translational Immunology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rae S. M.","family":"Yeung","sequence":"additional","affiliation":[{"name":"University of Toronto","place":["Toronto, Ontario, Canada"],"department":["Department of Immunology and Medical Science"]},{"name":"The Hospital for Sick Children","place":["Toronto, Ontario, Canada"],"department":["Division of Rheumatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A.","family":"Cafazzo","sequence":"additional","affiliation":[{"name":"University of Toronto","place":["Toronto, Ontario, Canada"],"department":["Institute of Health Policy, Management, and Evaluation"]},{"name":"University Health Network","place":["Toronto, Ontario, Canada"],"department":["Centre for Digital Therapeutics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost F.","family":"Swart","sequence":"additional","affiliation":[{"name":"Wilhelmina, Children\u2019s Hospital, University Medical Center Utrecht","place":["Utrecht, The Netherlands"],"department":["Department of Pediatric Rheumatology and Immunology"]},{"name":"Utrecht University","place":["Utrecht, The Netherlands"],"department":["Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"issue":"1","key":"pdig.0001655.ref001","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1038\/s41572-021-00332-8","article-title":"Juvenile idiopathic arthritis","volume":"8","author":"A Martini","year":"2022","journal-title":"Nat Rev Dis Primers"},{"key":"pdig.0001655.ref002","volume-title":"Juvenile idiopathic arthritis. 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